tbuckley/cabot-search huggingface dataset:
AB0391 ANALYSIS OF CLINICAL IMPROVEMENT BY 5 JAK INHIBITORS AGAINST JAK INHIBITOR iR RA PATIENTS IN JAPANESE CLINICAL PRACTICE
Authors: K. Katayama, M. Yuichi, H. Ito
Journal: Annals of the Rheumatic Diseases (2022)

Background Recently, Eular recommended different mode of therapeutic tool to get clinical remission. JAK inhibitors are considered to be one of candidates. Several JAK inhibitors have been used, however there are almost little informations about selection of JAK Inhibitors, especially, informations about secondary JAK for JAK inhibitor iR RA patients. Objectives To analyze clinical response by second JAK inhibitors against JAK inhibitor iR RA patientsin in clinical practice. Methods In Japan, five JAK inhibitors have been mainly used in MTX iR or biologics iR patients from 2013 (tofacitinib, JAK1,3), 2017 (baricitinib, JAK 1,2), 2019 (Peficitinib, Pan JAK, in Asia, Japan), 2020,April (upadacitinib, JAK1,2, mainly JAK1) and 2020.Nov (filgotinib, JAK1). In our clinic, these JAK inhibitors were sequentially used to get clinical remission. Numbers of patients who used JAK inhibitors are 28 patients in tofacitinib, 38 patients in baricitinib, 27 patients in peficitinib, 34 patients in upadacitinib, and 13 patients in filgotinib. Among them, 22 JAK inhibitor iR RA patients were investigated for clinical effectiveness. Results Summery of study were shown in Tables 1 and 2. Biologics were used in 14 patients and satisfied D2T RA (1 st row, green color). For pre JAK inhibitors, 12 tofacitinib, 6 baricitinib, 4 peficitinib have been used. JAK inhibitor for JAK inhibitor iR patients, 13 upadacitinib, 3 baricitinib, 3 peficitinib and 3 filgotinib were used. Six months later, 9/13 patients in upadacitinib, 2/3 in filgotinib, 2/3 in peficitinib, 0/3 in baricitinib, totally 13/22 improved clincal disease activity (Eular good+ moderate response). Clinical improvement about ACPA negative (6 th row, yellow color) patients, especially RF negative (5 th row, blue color) patients, are incomplete. Double negative (ACPA, RF)or RF negative may be a predicter for clinical response about 1 st and successive response for upadacitinib treated patients. Since, first JAK in 4 patients (8 th row, dark green)- 3 tofacitinb, 1 baricitinib respond well firstly (secondary unresponsiveness), tofacitinib may be useful for double negative or RF negative RA patients. Conclusion Jak inhibitors are useful for another JAK inhibitor iR RA patients in clinical practice. However, to get good response, baseline immunogenicity, RF/ACPA positivity, JAK specificity need to be considered. To solve, prospective clinical study may be required. References None Disclosure of Interests None declared
POS1473-HPR THE RELATIONSHIP BETWEEN PHYSICAL ACTIVITY LEVEL AND EXERCISE SELF-EFFICACY, BODY AWARENESS, AND FATIGUE SEVERITY IN RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL AND PILOT STUDY
Authors: M. Köprülüoğlu, İ. Naz, B. Dağ, G. Alp, D. Solmaz, S. Akar
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is a chronic inflammatory disease in which, for many reasons of the nature of the disease, patients tend to perform less physical activity (PA) than recommended in the guidelines (1). Many variables associated with a level of PA in patients have been described (2). However, there are limited studies about related factors with PA in RA patients. Objectives To investigate the relationship between PA level and exercise self-efficacy, body awareness, and fatigue severity in RA patients. Methods A total of 80 RA patients (women/men=61/19, age=56.83±11.56 years) who were diagnosed according to the ACR 2010 criteria and followed in university outpatient clinic were included in our study. All patients were assessed regarding physical characteristics (age, body-mass index), exercise status (yes/no), and occupational status (working/not working/retired). Physical activity level by International Physical Activity Questionnaire, exercise self-efficacy by Exercise Self-Efficacy Scale, body awareness by Body Awareness Questionnaire, and fatigue by Bristol Rheumatoid Arthritis Multidimensional Scale was assessed. Results Patients’ characteristics are presented in Table 1. It was observed that patients have low PA levels. Significant correlation was found between PA and exercise self-efficacy (r=0.410, p&lt;0.001), body awareness (r=0.374, p=0.001), and fatigue (r=-0.482, p&lt;0.001). Table 1. The characteristics of patients Mean ± SD, median (25/75 quartiles) or n (% ) Age, years 56.83 ±11.56 Body mass index, kg/m 2 27.84 ±5.57 Time of diagnosis, years 11.49 ±10.92 Exercise status Yes 53 (66.3) No 27 (33.8) Occupational status Working 16 (20.0) Not working 30 (37.5) Retired 34 (,42.5) IPAQ Walking, MET-min/week 371 (198/693) Moderate, MET-min/week 270 (0/840) Vigorous, MET-min/week 0 (0/0) Total, MET-min/week 693 (268/ 1533) IPAQ sub-group Inactive 55 (68.8) Minimal Active 19 (23.8) Very Active 6 (7.4) Exercise self-efficacy score, 0-1800 646.62 ±339.40 Body awareness score, 18-126 84.77 ±16.41 Bristol rheumatoid arthritis multidimentional fatigue score, 0-70 19.06 ±12.83 IPAQ: International Physical Activity Questionnaire. Conclusion Our study showed that RA patients had low PA and PA was related to exercise self-efficacy and fatigue moderately and body awareness weakly. We think that it may be important to assess these variables and to plan interventions to improve these variables while planning PA programs of the patients. References [1]Tierney M, Fraser A, Kennedy N. Physical activity in rheumatoid arthritis: a systematic review. J Phys Act Health. 2012;9(7): 1036–48. [2]Hernández-Hernández, M. V., &amp; Díaz-González, F. (2017). Role of physical activity in the management and assessment of rheumatoid arthritis patients. Reumatologia clinica, 13(4), 214–220. Disclosure of Interests None declared
POS1368 DIVERSITY OF HEMODYNAMIC TYPES IN CONNECTIVE TISSUE DISEASE ASSOCIATED PULMONARY HYPERTENSION: MORE THAN A SUBGROUP OF PULMONARY ARTERIAL HYPERTENSION
Authors: X. Dong, Y. Shi, Y. Xia, X. Zhang, J. Qian, J. L. Zhao, J. Peng, Q. Wang, L. Weng, M. LI, B. Du, X. Zeng
Journal: Annals of the Rheumatic Diseases (2022)

Background Connective tissue disease (CTD) associated pulmonary hypertension (PH) is classified as a subgroup of WHO group 1 PH, also called pulmonary arterial hypertension (PAH). However, not all CTD-PH fit the hemodynamic definition of PAH. This study investigates the diversity of hemodynamical types of CTD-PH, their different clinical characteristics and outcomes. Objectives This study investigates the diversity of hemodynamical types of CTD-PH, their different clinical characteristics and outcomes. Methods We performed a retrospective cohort study. CTD-PH patients underwent right heart catheterization (RHC) were enrolled and divided into WHO group1 PH, WHO group 2 PH and high output PH (PVR&lt;3WU and PAWP&lt;15mmHg) according to hemodynamic features. Patients with obvious lung diseases, left heart disease and pulmonary embolism were excluded. Baseline characteristics, inflammatory markers, autoantibodies, cardiac function status, echocardiogram parameters, hemodynamics and survival rates were compared. Results 207 CTD-PH patients were included, including 139 in WHO group 1 PH, 36 in WHO group 2 PH and 32 in high output PH. Incidence of anti-ribonucleoprotein antibody was lower in WHO Group 2 PH. High output PH is less severe, presenting lower NT-proBNP level, better WHO functional class, lower mPAP and PVR, higher cardiac output, and less cardiac remodeling. Among patients with elevated PAWP, combine pre&amp; post-capillary PH had higher mPAP and larger right ventricle diameter. Association of mild to moderate interstitial lung disease didn’t show significant difference in disease characteristics. Short-term survival was significantly worse in WHO group 2 PH, yet 5-year survival rates didn’t differ between groups. Conclusion Pre-capillary PH is not the only hemodynamic type of CTD-PH. Different types of CTD-PH present different clinical phenotypes and outcome. Carefully phenotyping PH in CTD-PH patients is important. Disclosure of Interests None declared
POS1370 INCREASED INFERIOR VENA CAVA WALL THICKNESS AS A SIGN OF VENOUS INFLAMMATION IN BEHÇET’S DISEASE
Authors: S. Kutluğ Ağaçkiran, M. Sunbul, H. Direskeneli, F. Alibaz-Oner
Journal: Annals of the Rheumatic Diseases (2022)

Background Vascular involvement of Behçet’s disease (BD) involves both arterial and venous vessels of all sizes [1]. Femoral (superficial, deep, and common) and popliteal veins are the most frequently affected veins. We have previously shown that femoral wall thickness is increased in BD patients and can be used as a diagnostic test [2]. However, many other sites including vena cava inferior/superior and pulmonary arteries may also be involved [3]. Despite the dominance of venous vessel involvement, there is limited data assessing the large veins in BD. Objectives In this study, we aimed to assess inferior vena cava wall thickness (IVC) by transthoracic echocardiography (TTE) in BD compared with healthy controls. Methods Patients with BD (n=70) and age and sex-matched healthy controls (n=51) were included in this study. Assessment of inferior vena cava (IVC) wall thickness was performed by an experienced cardiologist blinded to cases. Measurement of IVC wall thickness was made at end-expiration and approximately 0.5 to 2.0 cm proximal to the ostium of the right atrium as demonstrated in Figure 1. Figure 1. Measurement of inferior vena cava wall thickness by transthoracic echocardiography Results IVC wall thickness of patients with BD (0.29 mm (SD: 0.03) was significantly higher than healthy controls (0.26 mm (SD: 0.03) (p&lt;001). Although IVC wall thickness was higher in patients with BD with vascular involvement (0.30 mm (SD:0.04) and history of pulmonary embolism (0.30 mm (SD:0.04)), the difference did not reach statistical significance. There was no difference between IVC wall thicknesses in patients who used immunosuppressive and anti-TNF treatments due to major organ involvement, compared to those who did not. Similarly, no difference is observed between IVC thicknesses among Behçet’s patients according to age, gender, and activity status at the last visit. Although no correlation was found between IVC wall thicknesses, disease duration, and BDCAF scores at the last visit in the BD group, there was a low-grade correlation between age and IVC wall thickness (r=0.31, p=0.09) Conclusion Increased IVC wall thickness shows vasculitic involvement of large venous structures in BD and can be easily measured by TTE which is an easily accessible, noninvasive modality without radiation. The role of IVC wall thickness assessment for the diagnosis or management of BD requires further studies. References [1]Alibaz-Oner, F. and H. Direskeneli, Management of vascular Behçet’s disease. Int J Rheum Dis, 2019. 22 Suppl 1: p. 105-108. [2]Alibaz-Oner, F., et al., Femoral vein wall thickness measurement: A new diagnostic tool for Behçet’s disease. Rheumatology (Oxford), 2021. 60(1): p. 288-296. [3]Alibaz-Oner, F., et al., Behçet disease with vascular involvement: effects of different therapeutic regimens on the incidence of new relapses. Medicine (Baltimore), 2015. 94(6): p. e494. Disclosure of Interests None declared
AB0229 ACHIEVING GLUCOCORTICOID FREE MIGHT DECREASE RISK FOR CLINICAL FRACTURES IN PATIENTS WITH RHEUMATOID ARTHRITIS - TEN-YEAR FINDINGS FROM THE TOMORROW STUDY
Authors: K. Mamoto, T. Koike, T. Okano, Y. Sugioka, M. Tada, K. Inui, H. Nakamura
Journal: Annals of the Rheumatic Diseases (2022)

Background Patients with rheumatoid arthritis (RA) who have muscle weakness and stiff or painful joints might be at increased risk of falls and fractures. Objectives The present study prospectively investigates correlations between decreasing doses of glucocorticoid (GC) and the incidence of clinical fractures in patients with RA based on the ten-year findings of the TOMORROW study (UMIN000003876) that started in 2010. Methods We evaluated anthropometric parameters, bone mineral density, disease activity, RA medication, and the incidence of clinical fractures over a period of ten years in 202 patients with RA (mean age, 58.6 years; mean disease duration, 14.0 years). We also investigated the effects of GC doses on the incidence of clinical fractures over the same period in patients with RA using multivariate regression analysis. Results The incidence of clinical fractures for ten years in patients with RA was 0.036/person-year. There were 89 patients (44.1%) treated with GC at least once during ten years. The incidences of clinical fractures in patients with RA treated with and without GC during ten years were 0.052 and 0.026/person-year, respectively. After adjusting for fracture risk factors including age, sex, smoking, and body mass index, cox proportional hazard model revealed that GC dose of ≥ 2 mg/day at baseline was a significant risk factor for clinical fractures (Hazard ratio [HR]:2.430; 95%CI, 1.040-5.675, p=0.040). Although the risk for clinical fractures did not decrease by just reducing the dose of GC (HR:4.505; 95%CI, 0.589-34.457, p=0.147), it was significantly lower if the dose of GC could be reduced to zero during ten years (HR:0.407; 95%CI, 0.194-0.857, p=0.018). Conclusion Medication with even low dose of GC are apparently significantly associated with an increased frequency of clinical fractures among patients with RA. However, if the dose of GC was reduced to free during ten years, the clinical fracture risk could become lower. We concluded that we should decrease the dose of GC to free after controlling disease activity of RA. Disclosure of Interests None declared
AB0473 EFFECT OF THYROID LESIONS ON THE COURSE OF SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: A. Trofimenko, O. Emelyanova, O. Rusanova
Journal: Annals of the Rheumatic Diseases (2022)

Background Thyroid disease is a common complication of systemic lupus erythematosus manifesting in 30% of cases due to a disturbance of autoimmune mechanisms. Objectives evaluating the effect of thyroid lesion on the course of systemic lupus erythematosus based on clinical and laboratory parameters, and the level of antibodies to thyroid hormones. Methods Among 65 examined patients with SLE (63 women and 2 men aged 19-65) we revealed a thyroid disorder in a third of patients. Patients were diagnosed with autoimmune thyroiditis in 16 cases, nodular goiter (degree I and II), and single diffuse toxic goiter in 5 cases. The duration of the disease was 5 years, that concomitant thyroid diseases –– 3 years. The concentration of antibodies to thyroid hormones was determined by enzyme immunoassay using immobilized thyroxine and triiodothyronine. Results When the thyroid gland (TG) gets involved, there is a pronounced discordance in the parameters of immune and hormonal status in patients with SLE compared with patients without thyroid complications. It was found that 68% of patients had antibodies to nDNA, compared with 46% without concomitant thyroid lesion, CIC - 77% and 32%, respectively, IgG - 54% and 25%. The SLICC/ACR damage index in the SLE group with thyroid involvement was higher than in the second group: 4.55 and 3.6 points. This indicates an increase in the severity of SLE in patients with involvement of the thyroid gland. Joint involvement was seen in 79% with thyroid involvement, and 49% without thyroid involvement. A lesion of serous membranes in the form of pleurisy was in 39% and in 3% without involvement, that of the heart in 66/24%. Lupus erythematosus cell phenomenon in 44 / 31%. Immunological activity prevailed in the group of SLE patients with combined autothyroid disease. Among these patients, 100% had an elevated level of antibodies to thyroid-stimulating hormones, versus 15% in the group without autothyroid disease. Conclusion The involvement of the thyroid gland increases the severity of the course of SLE, antibodies to thyroid hormones are produced actively, which is indicative of thyrocyte destruction and of blocking the normal process of hormone synthesis by their antibodies. Disclosure of Interests None declared
AB0989 Plantar fasciitis in patients with knee osteoarthritis
Authors: S. Bouzid, S. Miladi, A. Fazaa, H. Bousaa, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2022)

Background Knee osteoarthritis (OA) is a highly prevalent disease, it shares with plantar fasciitis similar risk factors including aging, occupation, obesity, and inappropriate shoe wear. The association between knee OA and heel pain caused by plantar fasciitis has received limited attention to date. Objectives The aim of our study was to detect plantar fasciitis using ultrasound in patients with confirmed knee OA. Methods We conducted a cross-sectional study including 30 patients with symptomatic knee OA. Health status was evaluated using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index. The functional impairment of knee OA was determined by the Lequesne index. Ultrasound evaluation of heels was performed in all patients searching signs of plantar fasciitis (measure thickness, echogenicity, enthesopathy, calcification, erosion, doppler). Results The study included 30 patients. Mean age was 62.09 +/- 6.7 years. Patients reported lower back pain and heel pain in 67% (n=20) and 47% (n=14) respectively. Knee symptoms were evaluated by the WOMAC index: mean score for pain, stiffness, and physical function was 9.68 +/- 4.25, 4,18 +/- 7.55 and 27.27 +/- 16.39, respectively. Mean Lequesne index for the knee OA was 11,4 +/- 4,57. Physical examination revealed limited range of motion in knees in 33 % (n=10) with a genu flexum in two patients. Patella tap was positive in 20 % (n=6). Heel ultrasound revealed thickening of the plantar fascia in 50% (n=15). Other sonographic abnormalities found were loss of fibrillar structure in 26.7% (n=8), perifascial collections in 13.3% (n=4), calcifications in 16.7 % (n=5) and erosions in 33.3% (n=10). No correlation was found between health status attested by WOMAC index and the presence of plantar fasciitis. Conclusion Our study showed that half of our knee OA patients have plantar fasciitis confirmed with ultrasound. More studies with larger cohorts are needed to explain the correlation between the two lesions. Disclosure of Interests None declared
AB0128 IMMUNE RESPONSE GENE 1 (IRG1) IS DYSREGULATED IN SYSTEMIC SCLEROSIS
Authors: S. O’Reilly
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic sclerosis (SSc) is an autoimmune idiopathic connective tissue disease in which there is inflammation and fibrosis of the skin. The innate immune system is intricately linked in the disease. IRG1 is a gene that codes for an enzyme that is essentially to make itaconate a metabolite of the TCA cycle. Itaconate has recently been ascribed function in immunity by negatively regulating inflammation through mechanism that involve upregulation of nrf2 and possibly downregulation of nf-kb to act as a molecular rheostat to balance the positive and negative aspects of inflammation. IRG1 is known to be robustly upregulated in macrophages after LPS stimulation. Objectives To determine the expression of IRG1 in systemic sclerosis macrophages. Methods Early diffuse SSc patients (&lt; less than 2 years from first non-Raynaud’s symptom) had blood drawn and monocytes were isolated on CD14 using MACS. Healthy controls blood was also taken and CD14+ monocytes were isolated. All female (3 donors each). After isolation cells were differentiated to macrophages using M-CSF for a set period. After which they were treated with ultrapure LPS for 18 hours. Cells were lysed and mRNA expression for IRG1 and Nqo1 was quantified by qPCR. Data is normalized to housekeeping gene 18S for normalization. In some experiments macrophages were stimulated with the itaconate derivative 4 Octyl Itaconate (4OI) at 100 µM for 2 hours, then stimulated or not with LPS for a further 24 hours. IL-1β and IL-6 cytokines were measured by ELISA. Bleomycin mouse model of skin fibrosis was employed by repeated intra dermal injections of bleomycin or sodium chloride vehicle. Skin biopsies were taken in the lesioned skin and H&amp;E performed and fibrosis markers by qPCR was analysed. Results Healthy monocytes in response to LPS stimulation robustly upregulated IRG1 expression but in comparison to SSc monocytes this upregulated was significantly attenuated (n=3). Pretreatment of SSc monocytes with the itaconate derivative 4OI prior to LPS stimulation led to significantly reduced IL-1β and IL-6 secretion. The also led to upregulation of the nrf2 target gene Nqo1 6 fold compared to LPS treated alone. No difference in nf-kb was observed. mRNA expression of bleomycin skin found significantly downregulated nrf2 expression in association with elevated fibrosis markers compared to vehicle control treated mice (n=3 per group). Conclusion Failed upregulation of IRG1 in SSc macrophages may lead to a failure of inflammatory resolution and subsequent fibrosis. The itaconate derivative 4OI could be a possible anti-fibrotic through restoration of homeostasis via upregulation of nrf2 target genes. Disclosure of Interests Steven O’Reilly Employee of: I am employed by STipe therapeutics
The Multidimensional Burden of Atopic Dermatitis Among Adults
Authors: Rawaan Elsawi, Katie Dainty, Wendy Smith Begolka, Kelly Barta, Lisa Butler, Korey Capozza, Sanaz Eftekhari, Kathryn Z. Tullos, Wei Wu, Aaron M. Drucker
Journal: JAMA Dermatology (2022)

Atopic dermatitis (AD) is long term and burdensome. Studies investigating disease burden in adults are limited in scope with gaps in understanding of the adult patient lived experience.To describe the multidimensional burden of AD among mainly US adults.This survey study for an externally led patient-focused drug development meeting with the US Food and Drug Administration on adult patients with AD was conducted between August 1, 2019, and October 11, 2019. Data were analyzed betwean March 26, 2021, and June 29, 2021.We used multivariable ordinal regression to assess associations between demographic and clinical variables and patient-reported overall AD impact scores (ordinal scale from 1 [no impact] to 5 [significant impact]).Among 1065 survey respondents, 114 (11%) were aged 18 to 24 years, 235 (22%) were 25 to 34 years, 242 (23%) were 35 to 50 years, 288 (27%) were 51 to 64 years, and 186 (17%) were aged 65 years or older; 881 (83%) were women. Four hundred eighty-nine (46%) participants reported low-moderate AD impact scores (2-3), 544 (51%) reported high-significant impact scores (4-5), whereas 32 (3%) reported no association of AD with disease burden (impact score, 1). Variables strongly associated with overall impact scores were current AD severity (moderate: OR, 4.13; 95% CI, 2.94-5.79; severe: OR, 13.63; 95% CI, 8.65-21.50 vs mild), and time spent managing AD (11-20 hours: OR, 2.67; 95% CI, 1.77-4.03, ≥21 hours: OR, 5.34; 95% CI, 3.22-8.85, vs <5 hours).In this survey study, AD severity and time spent managing symptoms showed the strongest associations with disease burden. This analysis highlights the multidimensional burden of AD in adults and emphasizes the need for more effective treatment strategies that reduce the time patients spend managing their AD.